Stem rust, named for the blackening pustules that infect plant stems, caused devastating crop epidemics and famine for centuries before being tamed by fungicides and resistance genes.

Since the turn of the century, however, aggressive new strains have emerged that infect widely grown varieties of wheat – such as 'Ug99', first detected in Uganda in 1999. These diseases threaten to disperse trillions of pathogenic fungal spores on winds across countries and continents. The current global economic loss from wheat stem rust is approximately U.S. $1 billion a year.

The fear is that these airborne and highly virulent strains could spread from known sites to some of the world's most important 'breadbasket' regions, such as the Punjab in South Asia, where these strains have not yet been detected.

Now, a team of scientists of the University of Cambridge, the UK Met Office and CIMMYT (International Maize and Wheat Improvement Centre) have adapted modelling systems previously used to forecast, ash dispersal from erupting volcanoes and radiation from nuclear accidents (NAME), to predict when and how Ug99 and other such strains are most likely to spread.

The research, published today in the journal Nature Plants, quantifies for the first time the circumstances – routes, timings and outbreak sizes – under which dangerous strains of stem rust pose a threat from long-distance dispersal out of East Africa to the large wheat-producing areas in India and Pakistan.

The results highlight the role of Yemen as a potential 'stepping stone' for the transmission of the disease between continents. The key scenario for disease spread is from Yemen directly to Pakistan or India. In case of a large outbreak in Eastern Yemen results indicate a 30% chance for transmission to occur.

Another important scenario for wheat rust spread is from Yemen through Middle Eastern countries, in particular Iran, to Central and South Asia. If Iran were to suffer a moderate outbreak of Ug99 – more than 1000 hectares – then spores would likely spread to Afghanistan, and from there potentially further to the northern plains of Pakistan and India. However, transmission along this route is restricted to a relatively short time-window in March and April, before wheat is typically harvested in South Asia.

"New races of wheat rust are threatening wheat worldwide, and we need to know which areas are at risk," said senior author Prof Chris Gilligan, from Cambridge's Department of Plant Sciences.

"From our work, we now believe that if we start to see Ug99 or other new wheat rust strains take hold in Yemen in early spring then action must be taken immediately to mitigate the risk of further spread."

However, the modelling work also offers some encouraging news: the airborne transmission of the disease from East African countries directly to South Asia is highly unlikely, with transmission events possible only on less than one day a year.

The scientific team used field disease surveys from the International Maize and Wheat Improvement Centre and weather data from the UK Met Office as key input for the modelling framework.

"This research has allowed us to obtain the first quantitative estimates of long-term airborne spore transmission frequencies for different outbreak scenarios. We compiled risk assessments for pathogen dispersal from key disease locations to important wheat-producing countries. These assessments can effectively inform surveillance and control strategies," said Cambridge's Marcel Meyer, the study's first author.

The team say their work, including 3-D spore dispersal animations and a catalogue of dispersal trends (indicating likely directions, frequencies, pathogen loads), provides new ways to raise awareness, communicate risks, and inform agricultural stakeholders.

Their modelling framework can be applied as a tool to analyse risks in case new disease strains should be uncovered in other geographic areas. This has already helped in estimating dispersal risks from sites of other diseases in Europe and Siberia. In ongoing work the team is developing an Early Warning System forecasting rust risk in Ethiopia, East Africa's largest wheat producing country.

"The combined expertise from plant sciences and atmospheric dispersion sciences has delivered ground breaking tools that highlight the risks, and support the management of the devastating potential of these diseases," said Dr Matthew Hort, co-author from the UK's Met Office.

The researchers, from Cambridge, Southampton and Cardiff Universities in the UK and the Skolkovo Institute of Science and Technology in Russia, have used quantum particles known as polaritons – which are half light and half matter – to act as a type of ‘beacon’ showing the way to the simplest solution to complex problems. This entirely new design could form the basis of a new type of computer that can solve problems that are currently unsolvable, in diverse fields such as biology, finance or space travel. The results are reported in the journal Nature Materials.

Our technological progress -- from modelling protein folding and behaviour of financial markets to devising new materials and sending fully automated missions into deep space -- depends on our ability to find the optimal solution of a mathematical formulation of a problem: the absolute minimum number of steps that it takes to solve that problem.

The search for an optimal solution is analogous to looking for the lowest point in a mountainous terrain with many valleys, trenches, and drops. A hiker may go downhill and think that they have reached the lowest point of the entire landscape, but there may be a deeper drop just behind the next mountain. Such a search may seem daunting in natural terrain, but imagine its complexity in high-dimensional space. “This is exactly the problem to tackle when the objective function to minimise represents a real-life problem with many unknowns, parameters, and constraints,” said Professor Natalia Berloff of Cambridge’s Department of Applied Mathematics and Theoretical Physics and the Skolkovo Institute of Science and Technology, and the paper’s first author.

Modern supercomputers can only deal with a small subset of such problems when the dimension of the function to be minimised is small or when the underlying structure of the problem allows it to find the optimal solution quickly even for a function of large dimensionality. Even a hypothetical quantum computer, if realised, offers at best the quadratic speed-up for the “brute-force” search for the global minimum.

Berloff and her colleagues approached the problem from an unexpected angle: What if instead of moving along the mountainous terrain in search of the lowest point, one fills the landscape with a magical dust that only shines at the deepest level, becoming an easily detectible marker of the solution?

“A few years ago our purely theoretical proposal on how to do this was rejected by three scientific journals,” said Berloff. “One referee said, ‘Who would be crazy enough to try to implement this?!’ So we had to do it ourselves, and now we’ve proved our proposal with experimental data.”

Their ‘magic dust’ polaritons are created by shining a laser at stacked layers of selected atoms such as gallium, arsenic, indium, and aluminium. The electrons in these layers absorb and emit light of a specific colour. Polaritons are ten thousand times lighter than electrons and may achieve sufficient densities to form a new state of matter known as a Bose-Einstein condensate, where the quantum phases of polaritons synchronise and create a single macroscopic quantum object that can be detected through photoluminescence measurements.  

The next question the researchers had to address was how to create a potential landscape that corresponds to the function to be minimised and to force polaritons to condense at its lowest point. To do this, the group focused on a particular type of optimisation problem, but a type that is general enough so that any other hard problem can be related to it, namely minimisation of the XY model which is one of the most fundamental models of statistical mechanics. The authors have shown that they can create polaritons at vertices of an arbitrary graph: as polaritons condense, the quantum phases of polaritons arrange themselves in a configuration that correspond to the absolute minimum of the objective function.

“We are just at the beginning of exploring the potential of polariton graphs for solving complex problems,” said co-author Professor Pavlos Lagoudakis, Head of the Hybrid Photonics Lab at the University of Southampton and the Skolkovo Institute of Science and Technology, where the experiments were performed. “We are currently scaling up our device to hundreds of nodes, while testing its fundamental computational power. The ultimate goal is a microchip quantum simulator operating at ambient conditions.”

Reference:
Natalia G. Berloff et al. ‘Realizing the classical XY Hamiltonian in polariton simulators.’ Nature Materials (2017). DOI: 10.1038/nmat4971

The world's botanic gardens contain at least 30% of all known plant species, including 41% of all those classed as 'threatened', according to the most comprehensive analysis to date of diversity in 'ex-situ' collections: those plants conserved outside natural habitats.

The study, published today in the journal Nature Plants, found that the global network of botanic gardens conserves living plants representing almost two-thirds of plant 'genera' (the classification above species) and over 90% of plant families.

However, researchers from the University of Cambridge discovered a significant imbalance between temperate and tropical regions. The vast majority of all plants species grown ex-situ are held in the northern hemisphere.

Consequently, some 60% of temperate plant species were represented in botanic gardens but only 25% of tropical species, despite the fact that the majority of plant species are tropical.

For the study, researchers analysed datasets compiled by Botanic Gardens Conservation International (BGCI). They cross-referenced the working list of known plant species – currently sitting at 350,699 – with the species records of a third of botanic gardens on the planet, some 1,116 institutions. They say this provides a "minimum estimate" for the plant diversity held in botanic gardens.

However, while gardens hold approaching half all threatened species, just 10% of overall storage capacity is dedicated to such plants. The researchers argue that botanic gardens are of "critical importance to plant conservation", and internationally coordinated efforts are needed to house even more species at risk of extinction – particularly those from tropical climates.

"The global network of botanic gardens is our best hope for saving some of the world's most endangered plants," said senior author Dr Samuel Brockington, a researcher at Cambridge's Department of Plant Sciences as well as a curator at the University's own Botanic Garden.

"Currently, an estimated one fifth of plant diversity is under threat, yet there is no technical reason why any plant species should become extinct. Botanic gardens protect an astonishing amount of plant diversity in cultivation, but we need to respond directly to the extinction crisis.

"If we do not conserve our plant diversity, humanity will struggle to solve the global challenges of food and fuel security, environmental degradation, and climate change."

The plants not currently grown in botanic gardens are often more interesting than those that are, say the researchers. Hydrostachys polymorpha, for example, an African aquatic plant that only grows in fast flowing streams and waterfalls, or the tiny parasitic plant Pilostyles thurberi – only a few millimetres long, it lives completely within the stem tissue of desert shrubs.

Species from the most ancient plant lineages, termed 'non-vascular' plants, are currently almost undocumented in botanic gardens – with as few as 5% of all species stored in the global network. These include plants such as the liverworts and mosses.

"Non-vascular species are the living representatives of the first plants to colonise the land," said Brockington. "Within these plants are captured key moments in the early evolutionary history of life on Earth, and they are essential for understanding the evolution of plants."

From the spectacular new Gardens by the Bay in Singapore to London's own legendary Royal Botanic Gardens at Kew, the world's botanic gardens collectively host 500 million visitors a year.

"As a professional community, botanic gardens conserve and manage a far greater array of plant diversity than any other sector. However, we still have much to do." said Dr Paul Smith, study co-author and Secretary General of BGCI.

"This study is extremely important because it will enable us to target our efforts much more effectively, and work together to ensure that plant species don't needlessly become extinct," Smith said.

As life on earth comes under pressure as never before, with threats including habitat destruction, pollution, invasion by alien species and climate change, a complex, multifaceted response that transcends disciplines, organisations and borders is critical to the protection of the planet’s diversity. The future of humanity is also dependent on the living resources that we share this planet with, which provide many fundamental services such as oxygen, clean water and food.

The Cambridge Conservation Initiative (CCI) is a collaboration between 10 institutions, working together to address the most pressing issues facing our natural world. Cambridge is a natural home for this endeavour; in addition to the world-class research by University of Cambridge academics, the city is home to the largest cluster of conservation organisations in the world. These range from local, grassroots organisations through to long-established, international charities, as well as representatives of the United Nations, national government agencies, and intergovernmental secretariats. CCI bring these diverse networks together in new and innovative ways, generating novel ideas and approaches that no one institution could deliver alone. 

Two years ago CCI moved into a specially-created conservation campus within the David Attenborough Building, in the centre of Cambridge, which provides a unique collaborative hub in which CCI can integrate research, policy development and capacity building. Sir David Attenborough, after whom the building housing the CCI Conservation Campus is named, said: “I am delighted to see the work that the Cambridge Conservation Initiative is doing – it is clear to me that the most effective solutions to protecting nature are achieved by collaboration, which is exemplified by CCI’s vision and ethos. By making this gift, Lisbet Rausing and Peter Baldwin are investing to protect our planet’s life support system and providing an incredible legacy for the natural world.”

CCI’s Executive Director, Dr Mike Rands, confirmed that the endowment would provide the financial security to enable CCI to focus on scaling up its collaborations and engaging others, especially in business, governments and civil society, in the conservation of nature. “Lisbet Rausing and Peter Baldwin, through Arcadia, have been incredible partners to CCI. Their investment in the core of this Initiative is both brave and brilliant; brave because it is supporting a completely new approach to the conservation of biodiversity and brilliant because it adds value to worldwide conservation efforts by uniting the critical mass of skills and expertise that exists amongst CCI partners to work collaboratively and beyond organisational boundaries.”

By endowing the Cambridge Conservation Initiative, Arcadia are ensuring CCI’s future financial stability. In announcing the Arcadia grant, Lisbet Rausing referred to the unique nature of CCI and its potential, saying “CCI brings together leading academics and conservation practitioners to focus on the greatest problems facing our planet. We hope our grant will help these experts find new ways to protect nature and biodiversity.”

The Vice-Chancellor of the University of Cambridge, Professor Sir Leszek Borysiewicz, said: “Arcadia’s investment in this unique Initiative will ensure that Cambridge sustains a long term leadership role in conservation research, teaching and practice that will have a global impact. CCI is a great example of the benefits that can be achieved by bringing together practitioners and academia”. 

The most likely and immediate threat to our species is a global pandemic of highly infectious flu. Such a pandemic could be so serious that it currently tops the UK Government’s Risk Register.

Scientists from the University of Cambridge and London School of Hygiene and Tropical Medicine are attempting to collect a gold standard data set that can be used to predict how the next pandemic flu would spread through this country - and what can be done to stop it. They need your help.

UK residents can take part in the BBC Pandemic experiment simply by downloading the Pandemic app onto your smartphone via App Store or Google Play from today.

The app and results will be featured in a documentary on BBC Four in 2018, to be presented by Dr Hannah Fry and Dr Javid Abdelmoneim.

Data gathered via the app could be key in preparing for the next pandemic outbreak. In order to better understand how an infectious disease like flu can spread, researchers need data about how we travel and interact.

Two experiments will be conducted through the app: the National Outbreak, which is open to anyone in the UK from 27th September 2017; and the Haslemere Outbreak, a closed local study that is only open to people in the town of Haslemere, Surrey, and runs for 72 hours starting on Thursday 19th October 2017.

In the National Outbreak, the app will track your approximate movement at regular intervals over a 24 hour period – all data will be anonymised, so the app will not know exactly where or who you are. The app will also ask some questions about your journeys and the people you spent time with during those 24 hours.

All data collected will be grouped to ensure anonymity, and a research team from the University of Cambridge and the London School of Hygiene and Tropical Medicine will use it to predict how a flu pandemic might spread across the country – and determine what can be done to stop it.

Professor Julia Gog, who specialises in the mathematics of infectious diseases, and her colleagues from Cambridge’s Department of Applied Mathematics and Theoretical Physics have helped design the experiment and will be processing the data, running statistical analyses, and building and running the pandemic models.

“This will give us a chance to explore a range of different scenarios,” said Professor Gog. “This could the best data set we’ve ever had on the movement of people in the UK, and could help support future research projects to control infectious diseases – for a researchers like us, this is incredibly exciting.”

There are flu outbreaks every year but in the last 100 years, there have been four pandemics of a particularly deadly flu, including the Spanish Influenza outbreak which hit in 1918, killing up to 100 million people worldwide. Nearly a century later, a catastrophic flu pandemic still tops the UK Government’s Risk Register of threats to this country. Key to the Government’s response plan are mathematical models which simulate how a highly contagious disease may spread. These models help to decide how best to direct NHS resources, like vaccines and protective clothing. But the models are only as good as the data that goes into them.

The more people of all ages that take part in BBC Pandemic, the better that data will be.

By identifying the human networks and behaviours that spread a deadly flu, the app will help to make these models more accurate and, in turn, help to stem the next pandemic.

This project has been commissioned by the BBC, and is being undertaken in collaboration with researchers at the University of Cambridge and the London School of Hygiene and Tropical Medicine.

More information is available at the BBC website. 

As UK general practices struggle with rising demand from patients, more work being transferred from secondary to primary care, and increasing difficulty in recruiting general practitioners, one proposed potential solution is a ‘telephone first’ approach, in which every patient asking to see a GP is initially phoned back by their doctor on the same day. At the end of this phone call the GP and the patient decide whether the problem needs a face-to-face consultation, or whether it has been satisfactorily resolved on the phone.

Two commercial companies provide similar types of management support for practices adopting the new approach, with claims that the approach dramatically reduces the need for face-to-face consultations, reduces workload stress for GPs and practice staff, increases continuity of care, reduces A&E attendance and emergency hospital admissions, and increases patient satisfaction.

Some of these claims are repeated in NHS England literature, including the assertion based on claims from one of the companies that practices using the approach have a 20% lower A&E usage and that “the model has demonstrated a cost saving of approximately £100k per practice through prevention of avoidable attendance and admissions to hospital”. Several Clinical Commissioning Groups have subsequently paid for the management support required for the approach to be adopted by practices in their area.

The National Institute for Health Research (NIHR) acknowledged the need for robust and independent evaluation of current services and therefore commissioned the team led by Martin Roland, Emeritus Professor of Health Services Research at the University of Cambridge. The results of the evaluation, which looked at data sources including GP and hospital records, patient surveys and economic analyses, are published today in The BMJ.

The study found that adoption of the ‘telephone first’ approach had a major effect on patterns of consultation: the number of telephone consultations increased 12-fold, and the number of face-to-face consultations fell by 38%.

However, the study found that the ‘telephone first’ approach was on average associated with increased overall GP workload; there was an overall increase of 8% in the mean time spent consulting by GPs, but this figure masks a wide variation between practices, with some practices experiencing a substantial reduction in workload and others a large increase.

Dr Jennifer Newbould from RAND Europe, part of the Cambridge Centre for Health Services Research, the study’s first author, says: “There are some positives to a ‘telephone first approach’; for example, we found clear evidence that a significant part of patient workload can be addressed through phone consultations. But we need to be careful about seeing this as a panacea: while this may increase a GP practice’s control over day-to-day workload, it does not necessarily decrease the amount of time GPs spend consulting and may, in some cases, increase it.”

The researchers found no evidence that the approach substantially reduced overall attendance at A&E departments or emergency hospital admissions: introduction of the ‘telephone first’ approach was followed by a small (2%) increase in hospital admissions, no initial change in A&E attendance, but a small (2% per year) decrease in the subsequent rate of rise of A&E attendance. However, far from reducing secondary care costs, they found overall secondary care costs increased slightly by £11,776 per 10,000 patients.

Professor Roland adds: “Importantly, we found no evidence to support claims made by one of the companies that support such services – claims that have been repeated by NHS England – that the approach would be substantially cost-saving or reduce hospital referrals. This has resulted in some Clinical Commissioning Groups across England buying their consultancy services based on unsubstantiated claims. The NHS must be careful to ensure that it bases its information and recommendation on robust evidence.”

The study was funded by the National Institute for Health Research.

Reference                                                  
Newbould, J et al. Tele-First. Evaluation of a ‘telephone first’ approach to demand management in English general practice: observational study. BMJ (2017). DOI: 10.1136/bmj.j4197

Edward Lear’s bizarre and beautiful poem, The Owl and the Pussy-cat, was first published in 1871. Featuring an unlikely romance, a wedding ring purchased from a pig and a marriage officiated by a turkey, it’s been a favourite with people of all ages ever since. Who could fail to be charmed by an elegant fowl and a star-struck cat, dancing by the light of the moon?

In a survey that set out to find out what poems the British public are able to recall, The Owl and the Pussy-cat ranked top of 287 different poems submitted by more than 500 respondents. Second came Lewis Carroll’s “Jabberwocky” with its deliciously resonant language. And on the heels of the whiffling Jabberwock was Shakespeare’s romantic sonnet, “Shall I compare thee to a summer’s day?”

The nation has already been quizzed for its poetry favourites. In 1995, a BBC poll famously placed Rudyard Kipling’s If in prime position, and that was later trumped by Robert Frost’s Stopping by Woods on a Snowy Evening. But the Poetry and Memory Project at Cambridge University’s Faculty of Education delved deeper. As well as conducting the first survey to discover what poems people have actually learned, it aimed to find out about the effects of having poetry in our memory.

Collaborators Dr Debbie Pullinger and David Whitley explain: “We’re interested in the ways in which poetry learnt by heart inhabits our inner worlds. Our project was based on two central research questions. Firstly, what is the distinctive value of the memorised poem? And secondly, what is the relationship between memorisation and understanding?”

The survey elicited a surprisingly large number of poems, including some the researchers had never come across. Whitley says, “We were thrilled by the quality of the responses, which came from a surprisingly wide band of age groups. Many people were deeply reflective about why that poem had stuck and what it had come to mean to them over time – sometimes over a lifetime. The most popular poems were drawn from quite a conservative tradition, and were nearly all by long-dead, canonical poets.”

Most of the memorised poems had strong formal structures and rhyme schemes, which might be expected since these features make a poem easier to remember.

“It was interesting to see how humour and whimsy vied with more serious themes in the top rankings, and to see how both types can assume deep personal significance. Compared with the more earnest ‘educational’ canon taught in secondary school onwards, this more varied, informal canon may reflect a national sensibility in which humour is a vital ingredient,” says Whitley.

Memorisation and recitation are back on the primary English curriculum

The requirement for school children to learn and recite poetry was dropped from the UK curriculum in 1944, and these practices fell from favour. And although poetry’s roots are in the oral tradition, in modern times it has existed primarily on the printed page, where its rhythms and cadences fall silent. Stripped of its auditory pleasures, and often approached as a problem to be solved rather than a sensory and imaginative experience to be enjoyed, poetry came to be perceived as ‘difficult’.

In 2012, however, memorisation and recitation were back as statutory requirements on the primary English curriculum. Today’s school children, unlike most of their parents and teachers, are expected to learn verse. The move by Michael Gove, then Secretary of State for Education, met with a mixed reception from the teaching profession, say the researchers. Many teachers regard memorisation as an outdated and pointless exercise, and some feel it risks putting children off poetry for life.

As the Poetry and Memory Project confirmed, enforced learning by rote can have that undesirable effect. But, Pullinger explains, the picture is complicated. “While some people who have learned poems in a perfunctory way are put off, others come to understand and appreciate them over time. And there are many factors that influence our developing relationship with poetry,” she says.

"The overarching conclusion of the project is that committing a poem to memory appears to have real benefits. Almost all respondents not only reported that memorisation is a positive experience, but also associated it with a wide range of positive effects."

The most universal benefit was a deeper appreciation of the poem itself, and this was closely followed by the poem’s potential as an emotional resource. These findings were confirmed and illuminated in the second stage of the project, which followed up 38 people with in-depth interviews about their experience of learning poems and their relationship with poetry in general.

The emerging picture of the memorised poem is a multifaceted one. For many people, it forges a strong connection with a significant person. One participant realised how much poetry had meant to her late mother. “It might not have been the poetry I would’ve chosen because it was rather ‘rumpty tumpty’ stuff. But that was really part of her legacy to me.” For others, a particular poem was a powerful mnemonic, strongly associated with a time or place – a classroom, a holiday, a first love.

The memorised poem can also become a container for thoughts and emotions, described by respondents as “a place to inhabit”, “a temporary home while I was homeless” or “a place for your brain to be, if you’re challenged by other things”.

Responses suggested that once a poem is inside you, it can feel as if you are on on the inside of the poem. This sense of inhabiting may in turn open up a space in which understanding can unfold. As one interviewee said: “With some poems, I know the poem so well that I don’t have to think about them, and then I can sort of play around inside them, and different shades and meanings come to you.”

A memorised poem engages us with its sensory aspects

Having a poem installed, quite literally as part of our minds and bodies, engages us with its sensory aspects. “Although printed words are a necessary cue to performance, they can also act as a kind of interference,” says Pullinger.

“Hearing a poem without sight of the text can be a revelation. Our mind is free to attend to tasks other than decoding and our mind's eye is free to roam. Putting the book down is a bit like taking the stabilisers off the bike. You may be a bit wobbly at first, but only then can you really feel the way the bike is moving over the surface; only then can you find your balance.”

Although more than 70% of respondents had learned a poem as a child because a teacher required or suggested it, more than 85% had learned a poem as an adult for personal pleasure. Whitley says he, like many respondents, learned the odd poem in school, and went on to memorise poems that struck a chord with him at various points throughout his life. It’s the poems memorised in adolescence and early adulthood that have really stayed with him.

Pullinger, on the other hand, says that she rediscovered the pleasures of poetry relatively late in life. She learned many poems as a child, all now largely forgotten. But, inspired by the stories of her interviewees, she has tried various memorisation techniques for herself and is now an enthusiastic advocate of poetry learning. “Yes, it does seem that there is something special about committing a poem to memory," she says."You’ve invested in it and made it yours. Learning, giving voice and understanding – these all go hand in hand.”

The research evidence points strongly towards memorised poetry being a resource with the potential to enrich lives in many different ways over many years. Pullinger believes that the Poetry and Memory Project has staked out some fascinating and potentially important territory: “There is definitely more to learn about the way we experience poetry and poetic language,” she says.

The Poetry and Memory Project was based in the Faculty of Education and funded by the Leverhulme Trust. www.poetryandmemory.com

The results, published in BMJ Open, and funded by the National Institute for Health Research (NIHR), come from the first UK-based trial of its kind and show that patients using the HeLP-Diabetes programme have better diabetes control after 12 months.

“Diabetes is an NHS priority, with around 4 million people in England living with type 2 diabetes. This self-management tool offers an evidence based and cost effective way to improve health outcomes, for patients both at the beginning and later on in their diagnosis, that could be offered as part of the current menu of self-management support,” said Professor Elizabeth Murray of University College London, the paper’s first author.  

Clinicians at Whittington Health and researchers from University of Cambridge and UCL compared diabetes control and diabetes related stress in a randomised group of 374 patients from 21 general practices in England whose average age was just under 65 years. 185 patients used the HeLP-Diabetes programme developed at UCL, and a control group of 189 patients used information from a static, text-based website.

Anonymised clinical data were collected for a diabetes control molecule called glycated haemoglobin (HbA1c) and diabetes related stress data were collected via a patient self-report questionnaire where patients score themselves from 1 to 100 (higher scores indicating more stress) against 20 items focusing on areas that cause difficulty in everyday life.

Glycaemic control was chosen as an outcome measure as poorly controlled diabetes is associated with premature mortality and risk complications, such as cardiovascular disease. Participants made it a priority that disease related stress was also a primary outcome measure as around 40% of patients with diabetes have significant level of distress, severely impacting their quality of life.

The mean baseline for HbA1c was 7.3% but by the end of the trial participants in the HeLP-Diabetes group had a lower HbA1c than those in the control group (7.22% and 7.46% respectively). It is considered that this reduction of 0.24% across a population level could translate into considerable population benefit as each 1% reduction in HbA1c is associated with a risk reduction of 21% for deaths related to diabetes and a 37% risk reduction for microvascular complications.

While there was no significant overall difference between groups for diabetes related stress, it was highlighted that the baseline for diabetes related stress was exceptionally low in the trial population group. However, patients that had diabetes for less than seven years showed a beneficial impact - suggesting that early intervention could be key.

“This is an important step forward in helping people living with type 2 diabetes to take control of their health,” said Dr Michael Sweeting of Cambridge’s Department of Public Health and Primary Care, who was chief statistician in the trial. “Based on the results from this trial, we can be confident in the value of online programmes to help people manage chronic conditions effectively.”

“Although historically group-based sessions have been a popular choice for health care providers, online programmes offer individuals the flexibility to access support that fits around their lifestyle. All the content in our programme was evidence based drawing on a range of diabetes management research including behavioural change, accessibility and usability, and promoting emotional wellbeing by drawing on principles of cognitive behavioural therapy and mindfulness,” added Professor Murray.

“Giving people the skills to look after their diabetes is at the heart of what we do. As well as helping develop the website, our patients were involved at the very start. It was wonderful to see how people accessing the HeLP-Diabetes programme, to help track and monitor their condition, were able to keep their diabetes in check. We hope to see this initiative made widely available, so that many more people with diabetes can benefit from this exciting new development,” said Dr Maria Barnard, Lead Consultant in Diabetes, Whittington Health.

Reference:
Murray, Elizabeth et al. ‘Web-based self-management support for people with type 2 diabetes (HeLP-Diabetes): randomised controlled trial in English primary care’ BMJ Open (2017). DOI: 10.1136/bmjopen-2017-016009

​Adapted from a UCL press release.

These awards highlight the BBC’s commitment to the short story form and to bringing it to a wider audience. The University of Cambridge will support all three of the awards and the charity, First Story, will become a partner for the BBC Young Writers’ Award and the Student Critics' Award. The partners replace BookTrust who have been working as a partner with the BBC since 2006.

Dr Sarah Dillon, lecturer in English Literature and Film at the University of Cambridge, said

‘The University of Cambridge has a rich heritage of investigating storytelling for eight hundred years and in that time we have produced many acclaimed creative writers including those who excel at the short story form such as A.S. Byatt, Helen Oyeyemi and Zadie Smith. The BBC shares more stories with more people than any other organisation in the world, and both organisations have an outstanding reputation for excellence and literary merit. The combined strengths of Cambridge and the BBC with First Story will make this a powerful and productive partnership.”

The new partnership heralds an expanded programme of activity around the awards. A short story symposium will be hosted by the new University of Cambridge Centre for Creative Writing at Madingley Hall, the Institute of Continuing Education’s campus. The symposium is aimed at new writers and anyone interested in short stories and creative writing and will include writing workshops and talks by established authors. Cambridge will host the 2018 prizegiving, with a special short story edition of the BBC Radio 4 programme Front Row which will be broadcast live from the University Library. The Cambridge School of Arts and Humanities will also host First Story’s Young Writers’ Festival for 600 young people in 2018.

Bob Shennan, Director of BBC Radio, said:

“I’d like to warmly welcome both of our new partners as we continue to champion brilliant storytelling across the BBC, including these awards on Radio 1 and Radio 4. We are the biggest commissioner of short stories and these awards are very much part of our commitment to bring our listeners the best new writing both from established and emerging talent. We greatly appreciate the support of our new partners, and I’d also like to thank BookTrust for their work with us over the past decade.”

The BBC Young Writers’ Award and the BBC Student Critics’ Award enhance the offering for young people, with the aim of inspiring the next generation of readers and writers of short stories. Entrants to the Young Writers’ Award will have the opportunity to write their own short stories inspired by a treasure trove of literary artefacts, as the Cambridge University Library opens up its digital archives for writing prompts. Through the Student Critics’ Award selected 16–18 year olds around the UK will read, listen to, discuss and critique the five stories shortlisted for the NSSA and have their say. They will have access to discussion guides and teaching resources created with BBC Learning, and in-school events with writers, judges, First Story networks, and staff and students from the Faculty of English at the University of Cambridge.

Di Speirs, Books Editor for BBC Radio said: “The launch of our new three-way partnership with the University of Cambridge and First Story is a hugely exciting moment. The BBC National Short Story Award and the BBC Young Writers’ Award have made a genuine difference to individual writers and to the literary landscape over the past twelve years. The Student Critics’ Award will foster a new generation of readers alongside our exciting plans for writers of all ages. We share with our partners a commitment to inspiring new writers and readers and to championing the very best short story writing in the UK.”

The prizes for both the BBC National Short Story Award and the BBC Young Writers’ Award remain the same. The five writers shortlisted for the BBC NSSA will all be celebrated individually on Radio 4: as in previous years, the stories will be read on Radio4 and the authors will be interviewed on Front Row, followed by a live edition of the programme where the winner is announced. For the Young Writers’ Award, the shortlist will have their stories published on the BBC Radio 1 website and the winning story will be broadcast on Radio 1. The awards will open for entry in December 2017.

A creative writing course at the Institute of Continuing Education

The University of Cambridge Centre for Creative Writing offers a wide range of part-time and short courses, from one-day classes right up to a part-time Master’s degree. Students from all backgrounds and levels of experience can take part. For more information about the Centre go to: www.ice.cam.ac.uk/centre-creative-writing

More information about the Awards can be found at: www.bbc.co.uk/nssa

The researchers, from ETH Zürich, Princeton, and the University of Cambridge, conducted the first global assessment of different intervention policies that could help limit the projected increase of antimicrobial use in food production. Their results, reported in the journal Science, represent an alarming revision from already pessimistic estimates made in 2010, pushed up mostly by recent reports of high antimicrobial use in animals in China.

In modern animal farming, large quantities of antimicrobials are used for disease prevention and for growth promotion. “Globally, animals receive almost three times as many antibiotics than people, although much of this use is not medically necessary, and many new strains of antibiotic-resistant infections are now common in people after originating in our livestock,” said co-author Emma Glennon, a Gates Scholar and PhD student at Cambridge’s Department of Veterinary Medicine. “As global demand for meat grows and agriculture continues to transition from extensive farming and smallholdings to more intensive practices, the use of antimicrobials in food production will increasingly threaten the efficacy of these life-saving drugs.”

Global policies based on a user fee and stricter regulation could help mitigate those ominous projections. “Under a user fee policy, the billions of dollars raised in revenues could be invested in the development of new antimicrobial compounds, or put towards improving farm hygiene around the world to reduce the need for antibiotics, in particular in low- and middle-income countries,” said Dr Thomas Van Boeckel from ETH Zurich, the study’s first author.

Compared to a business as usual scenario, a global regulation putting a cap of 50 mg of antimicrobials per kilogram of animal per year in OECD countries could reduce global consumption by 60% without affecting livestock-related economic development in low-income countries.

However, such a policy may be challenging to enforce in resource-limited settings. An alternative solution could be to impose a user fee of 50% of the current price on veterinary antimicrobials: this could reduce global consumption by 31% and generate yearly revenues of between US$ 1.7 and 4.6 billion.

An important limiting factor in performing this global assessment was accessing sufficient data on veterinary antimicrobial sales volumes and prices. The present study is based on publicly available data, limited to 37 countries. Representatives from the animal health industry were approach for this study but all declined to share information on antimicrobial sales or prices.  

The research was funded by the program for Adaptation to a Changing Environment, the ETH postdoctoral fellowship program and the European Research Council.

Reference:
Thomas P. Van Boeckel et al. ‘Reducing global antimicrobial use in food animals.’ Science (2017). DOI: 10.1126/science.aao1495

Fear and forests, writes Shakespeare scholar Professor Anne Barton, go hand in hand. Forests are where we get lost and meet wild men, where chaos rules and anything can happen. Shakespeare uses forest settings, sometimes magical, sometimes menacing, in many of his plays. In As You Like It, the Forest of Arden is a place of freedom, transformation and love – but also hardship for the shepherds who work there. When in Macbeth Birnam Wood does come to Dunsinane, Macbeth knows he is doomed.

Barton, who died in 2013, was Professor of English and a Fellow of Trinity College, Cambridge. Her many published works included Essays, Mainly Shakespearean (1994) and Ben Jonson, Dramatist (1984), and she was also an influential editor of Shakespeare’s plays. She was vitally interested in performance and staging, and her work has substantially altered and enriched the ways in which Shakespeare and other early modern dramatists have been understood and performed.

Now Cambridge University Press has published The Shakespearean Forest, Anne Barton’s final book, based in part on her Clark Lectures in 2003. It has been prepared for publication by Dr Hester Lees-Jeffries, a former research assistant to Barton and now a Shakespeare scholar herself, and a University Lecturer in the Faculty of English. In an editor’s note, Lees-Jeffries describes Barton’s seminars, held in her beautiful rooms at Trinity College, as often intimidating but always with a sense of occasion.

Woods and forests in the English language

The six chapters of The Shakespearean Forest set the playwright’s work within a historical, social and literary world of forests, as well as exploring the surviving evidence for the ways in which forests might have been staged in the early modern theatre. The opening chapter reminds us how big a part woodland plays in the story of the British Isles. The English language is rich with references to wood and woods. We talk about ‘not being able to see the wood for the trees’ and ‘not being out of the woods yet’. We ‘touch wood’ to forestall ill fortune.

If Britain is wooded today, it was much more so in Shakespeare’s lifetime. The names of these forests and woods entered the lexicon. The maiden name of Shakespeare’s mother Anne was Arden. His birthplace, the town of Stratford-upon-Avon, was once surrounded by the ancient woodland of the Forest of Arden. It was even said that a squirrel could jump from tree to tree right across the county of Warwickshire.

But this forest was already in decline in Shakespeare’s time. Trees provided timber for house and ship building, fuel for cooking and heating. In his Description of England in 1587, William Harrison commented that both England and Wales “have sometimes been very well replenished with great woods and groves, although at this time the said commodity be not a little decayed in both”.  

Shakespeare wrote for the ‘wooden O’, as the open-air, timber-framed Globe Theatre is described in the Prologue to Henry V. The origin of many of our current environmental anxieties can be found in the early modern period, and in the writings of Shakespeare and his contemporaries; they too were concerned by deforestation and pollution. Like the theatre itself, the forest is a place of transformation, growth and change.

Hunters, poachers and wild men of the woods

Forests were all about hunting – a pastime seen as preparation for warfare. Complex laws gave royalty rights and privileges to hunt deer and boar. Elizabeth I was a keen hunter, as well as being readily associated by poets in her courtly cult with Diana, virgin goddess of the hunt. Her successor James’ passion for the chase, writes Barton, “verged on the pathological”. He even insisted on being lowered into the gaping bellies of dead stags in the belief that the blood would strengthen his ankles.

Poaching was widespread and, though illegal, was not regarded as socially disreputable. The gentry, and even nobility, engaged in poaching – either for fun or to pursue family vendettas. Popular tradition holds that Shakespeare, too, may have been a poacher in his youth. Barton paints a vivid portrait of a group of poachers as a motley crew of unruly thrill-seekers united by blood-thirsty machismo.

“Heavily armed […] accompanied by a remarkably democratic mixture of friends, eager household servants, and people from the local village (sometimes including the vicar), men who had deer parks of their own, regularly broke into those of their neighbours, viciously assaulting keepers and killing more game than they could carry away.”

More benignly, green men and woodwoses (wild men of the woods) are key characters in the dramatis personae encountered in fields, woods and forests. In medieval churches and cathedrals, leaf masks are carved into stonework as decorative motifs, stubborn leftovers from a pagan past. They are, observes Barton, “reminders that forests are places of transformation, where the boundary between human life and that of animals, plants or trees are likely to become confused, or even obliterated”.

While for other dramatists, wild men were “a vogue that peaked and faded”, writes Barton, “Shakespeare’s interest in wild men seems to have extended throughout his writing career, taking in Oliver [As You Like It], Timon [Timon of Athens], the dancers in Bohemia [The Winter’s Tale], Caliban [The Tempest], Cardenio [The History of Cardenio] and (in a sense) Herne the Hunter in The Merry Wives of Windsor.” Elsewhere in the book she explores the various traditions of Robin Hood and Merlin the enchanter, both of whom make appearances in plays by Shakespeare’s contemporaries, including Ben Jonson.

How did Shakespeare bring the forest to his audiences?

A central question of Barton’s work is how Shakespeare might have brought the physicality of forest and woodland to the stage. There is no documentary evidence to show how early performances of Shakespeare’s plays led audiences deep into the woods. The only clue comes from the Netherlands in form of an engraving, dated 1635, which shows an elaborate indoor stage at a fair. In the background two tall trees are visible, perhaps waiting their moment in the next scene.

To exemplify the effort and expense invested in creating spectacular entertainment, Barton describes in detail the extraordinary artificial forest commissioned by Henry VIII for a pageant performed to celebrate the birth of a son on New Year’s Day 1511. ‘La Forrest Salvigne’ took the form of a rolling stage (requiring 40 men to propel it) complete with a magnificent forest from which the king and three companions appeared, mounted on horseback and fully armed.

According to meticulous accounts kept by an official, this forest comprised 12 hawthorns, 12 oaks, 12 hazels, 10 maples. 10 birches, 16 dozen fern roots and branches, 60 broom stalks and 16 furze bushes. Also present were 6 fir trees, holly, ivy, fennel stalks and 2,400 acorns and hazelnuts. Most of these items (including the nuts and acorns) were not gathered from the countryside but man-made. As Barton writes: “The individual shapes and sizes of its myriad leaves, for instance, were delicately cut from fine sarsnet, a fine silk material, and then backed with stiffened paper.”

Barton’s interest in the staging of Shakespeare’s plays reflects the way her own life brought together the worlds of theatre and academia, not least in her marriage to the director John Barton. In an afterword to The Shakespearean Forest, Shakespeare scholar Professor Peter Holland writes that many of Barton’s students became actors and directors and that many of her research students (including Holland himself) wrote dissertations centrally concerned with the questions of performance in early modern drama.

Holland writes: “Performance inflected her approach to plays and nothing in her writing […] allowed plays to be analysed as if their narratives could be divorced from the rhythms of performance.”

The Shakespearean Forest by Anne Barton is published by Cambridge University Press.

Inset image: map of Warwickshire from 'The theatre of the empire of Great Britaine' (1611) (Atlas 2.61.1, Cambridge University Library)

Two herpes simplex viruses infect primates from unknown evolutionary depths. In modern humans these manifest as cold sores (HSV1) and genital herpes (HSV2).

Unlike HSV1, however, the earliest proto-humans did not take HSV2 with them when our ancient lineage split from chimpanzee precursors around 7 million years ago. Humanity dodged the genital herpes bullet – almost.

Somewhere between 3 and 1.4 million years ago, HSV2 jumped the species barrier from African apes back into human ancestors – probably through an intermediate hominin species unrelated to humans. Hominin is the zoological ‘tribe’ to which our species belongs. 

Now, a team of scientists from Cambridge and Oxford Brookes universities believe they may have identified the culprit: Paranthropus boisei, a heavyset bipedal hominin with a smallish brain and dish-like face.

In a study published today in the journal Virus Evolution, they suggest that P.boisei most likely contracted HSV2 through scavenging ancestral chimp meat where savannah met forest – the infection seeping in via bites or open sores.

Hominins with HSV1 may have been initially protected from HSV2, which also occupied the mouth. That is until HSV2 “adapted to a different mucosal niche” say the scientists. A niche located in the genitals.

Close contact between P.boisei and our ancestor Homo erectus would have been fairly common around sources of water, such as Kenya’s Lake Turkana. This provided the opportunity for HSV2 to boomerang into our bloodline.

The appearance of Homo erectus around 2 million years ago was accompanied by evidence of hunting and butchery. Once again, consuming “infected material” would have transmitted the virus – only this time it was P.boisei being devoured.

“Herpes infect everything from humans to coral, with each species having its own specific set of viruses,” said senior author Dr Charlotte Houldcroft, a virologist from Cambridge’s Department of Archaeology. 

“For these viruses to jump species barriers they need a lucky genetic mutation combined with significant fluid exchange. In the case of early hominins, this means through consumption or intercourse – or possibly both.”

“By modelling the available data, from fossil records to viral genetics, we believe that Paranthropus boisei was the species in the right place at the right time to both contract HSV2 from ancestral chimpanzees, and transmit it to our earliest ancestors, probably Homo erectus.”

When researchers from University of California, San Diego, published findings suggesting HSV2 had jumped between hominin species, Houldcroft became curious. 

While discussing genital herpes over dinner at Kings College, Cambridge, with fellow academic Dr Krishna Kumar, an idea formed. Kumar, an engineer who uses Bayesian network modelling to predict city-scale infrastructure requirements, suggested applying his techniques to the question of ancient HSV2.

Houldcroft and her collaborator Dr Simon Underdown, a human evolution researcher from Oxford Brookes, collated data ranging from fossil finds to herpes DNA and ancient African climates. Using Kumar’s model, the team generated HSV2 transmission probabilities for the mosaic of hominin species that roamed Africa during “deep time”.  

“Climate fluctuations over millennia caused forests and lakes to expand and contract,” said Underdown. “Layering climate data with fossil locations helped us determine the species most likely to come into contact with ancestral chimpanzees in the forests, as well as other hominins at water sources.”

Some promising leads turned out to be dead ends. Australopithecus afarensis had the highest probability of proximity to ancestral chimps, but geography also ruled it out of transmitting to human ancestors.

Ultimately, the researchers discovered the key player in all the scenarios with higher probabilities to be Paranthropus boisei. A genetic fit virally who was found in the right places to be the herpes intermediary, with Homo erectus– and eventually us – the unfortunate recipients. 

“Once HSV2 gains entry to a species it stays, easily transferred from mother to baby, as well as through blood, saliva and sex,” said Houldcroft.

“HSV2 is ideally suited to low density populations. The genital herpes virus would have crept across Africa the way it creeps down nerve endings in our sex organs – slowly but surely.”

The team believe their methodology can be used to unravel the transmission mysteries of other ancient diseases – such as human pubic lice, also introduced via an intermediate hominin from ancestral gorillas over 3 million years ago.    

He was formally admitted to the office of Vice-Chancellor at a ceremony held this morning in the University’s Senate House.

The new Vice-Chancellor was previously Director of the University of Toronto’s Munk School of Global Affairs. Between 2006 and 2014 he served as President and Vice-Chancellor of the University of British Columbia.

In his inaugural address to the University, Professor Toope, a Trinity College alumnus, said: “This day feels like a return to familiar ground: my time as a PhD student at Cambridge was personally rewarding and career-defining. What I learned then has stayed with me, and served me well, ever since. So I am thrilled to return to serve an institution from which I gained so much.”

Born in Montreal, Canada, Stephen Toope studied History and Literature at Harvard University before earning degrees in common law and civil law at McGill University. At Trinity College, Cambridge, he completed a Ph.D. under the supervision of Sir Derek Bowett.

Professor Toope’s academic interests are in international law, human rights, international legal theory and international development.

Addressing the Congregation at Senate House, the new Vice-Chancellor said: “No single country or discipline can have exclusive purchase on how we attack today’s fundamental problems – nor can a single institution, no matter how high in the league tables."

"With its breadth and depth of expertise, with its history of truly disruptive discovery, Cambridge must take a global lead as the place where barriers between areas of knowledge are broken down, the place where global collaborations are seeded and nurtured.”

Full transcript of the Vice-Chancellor's speech:

Today the University of Cambridge launches #vlogbridge, a competition to find the best 60 second film made by and starring a student, about their first year.

Ibrahim Mohammed, better known as Ibz Mo, one of Cambridge's leading student YouTubers, is helping to launch the competition.

In a film accompanying the launch, he tells students: "Vlogging has changed my life - in the space of six months I was able to make new friends, network with businesses.

"On a daily basis I get messages from my amazing followers telling me how I've inspired them to apply here at Cambridge and that relationship with your followers is the best thing about this journey."

Ibz will also be one of the judges, along with Master of Selwyn College Roger Mosey and head of the University digital communications team Barney Brown. 

The winner will receive £200 worth of video equipment, plus expert mentoring from the University communications team. The best films will also feature on the University's social media channels. 

The competition closes on 5 December 2017 and the winner will be announced at the start of the Lent Term.  

Submit your film in an Mp4 format via WeTransfer or Dropbox through the following email address: digitalcommunications@admin.cam.ac.uk.

Please make the subject of the email Vlogbridge and include your name and CRS ID, along with a brief description of your film in the body of the email.

See the full terms and conditions.

Henderson completed his PhD in 1970, carrying out his research under the supervision of David Blow at the Medical Research Council Laboratory of Molecular Biology, where he is currently based. He is an Emeritus Fellow of Darwin College and an Honorary Fellow of Corpus Christi.

Frank, now based at Columbia University, New York, USA, was a senior research associate at Cambridge’s Cavendish Laboratory from 1973-1975.

The three researchers have received the award "for developing cryo-electron microscopy for the high-resolution structure determination of biomolecules in solution". According to the Nobel Committee, this method “has moved biochemistry into a new era”.

Dr Luca Pellegrini from the Department of Biochemistry at the University of Cambridge said: "We’re delighted about the news that the 2017 Nobel prize in Chemistry was jointly awarded to Dr Richard Henderson of the MRC Laboratory of Molecular Biology in Cambridge. The award recognises Dr Henderson’s long-standing interest in electron microscopy and its application to fundamental biological problems.

"The pioneering research carried out by Dr Henderson in the field of electron microscopy has revolutionised the structural investigation of biological specimens under native conditions, leading to a major breakthrough in our ability to obtain high-resolution images of macromolecular assemblies of biological and medical interest."

Professor Magdalena Zernicka-Goetz, from the Department of Physiology, Development and Neuroscience, said: “I think it is wonderful. A visual image is the essential component to understanding, often the first one to open our eyes, and so our minds, to a scientific breakthrough.”

This brings the total number of affiliates of the University of Cambridge who have been awarded the Nobel Prize to 98.

In a study published in the journal BMC Geriatrics, the researchers argue that their findings highlight the need to improve training in end-of-life care for all staff, in all settings, and in particular to address the current shortage of palliative care doctors in the NHS.

As life expectancy increases, so more and more people are dying at increasingly older ages, often affected by multiple conditions such as dementia, heart disease and cancer, which make their end-of-life care complicated. In the UK, in just a quarter of a century the proportion of deaths occurring at the age of 85 or older has risen steeply from around one in five in 1990 to almost half of all current deaths.

Older people living with dementia commonly report multiple symptoms as they approach the end-of-life, and if these symptoms are not adequately controlled, they may increase distress and worsen an individual’s quality of life.

While some people close to the end-of-life may prefer to die at home, only a minority of the ‘oldest old’ (those aged 85 years and above) actually die in their own homes. In the UK, fewer older people die in hospices or receive specialist palliative care at home than younger age groups, and the trend for older deaths is gradually moving away from death in hospital towards long-term care facilities.

Little is known about symptom control for ‘older old’ people or whether care in different settings enables them to die comfortably. To address this gap in our knowledge, researchers from the Cambridge Institute of Public Health examined the associations between factors potentially related to comfort during very old people’s final illness: physical and cognitive disability, place of care and transitions in their final illness, and place of death. This involved a retrospective analysis of data for 180 study participants aged between 79 and 107 years.

The researchers found that just one in 10 participants died without symptoms of distress, pain, depression, and delirium or confusion, and most people had in fact experienced combinations of two or more of these symptoms. Of the treatable symptoms reported, pain was addressed in the majority, but only effectively for half of these; only a fraction of those with depression received treatment for their symptom.

Compared with people who died in hospital, the odds of being reported as having died comfortably were four times as high for people whose end-of-life care had been in a care home or who died at their usual address, whether that was their own home or a care home.

People living in the community who relied on formal services for support more than once a week, and people who were cared for at home during their final illness but then died in hospital, were less likely to have reportedly died comfortably.

“How we care for the oldest members of society towards the end of their lives is one of the big issues for societies across the world,” says Dr Jane Fleming from the Department of Public Health and Primary Care, the study’s first author. “The UK is not the only country where an urgent review of the funding for older people’s long-term care is needed, along with commitments to staff training and development in this often undervalued sector.

“It’s heartening that the majority of very old people in our study, including those with dementia, appear to have been comfortable at the end-of-life, but we need to do more to ensure that everyone is able to die comfortably, wherever they are.”

The authors of the study argue that it highlights the need to improve training in end-of-life care for all staff, at all levels and in all settings.

“Improving access to supportive and palliative care in the community should be a priority, otherwise staying at home may not always be the most comfortable setting for end-of-life care, and inadequacies of care may lead to admission before death in hospital,” adds co-author Dr Morag Farquhar, who is now based at the University of East Anglia.

Contrary to public perceptions, the authors say their study demonstrates that good care homes can provide end-of-life care comparable to hospice care for the very old, enabling continuity of care from familiar staff who know their residents. However, they say, this needs recognising and supporting through valuing staff, providing access to training and improving links with primary and community healthcare providers.

“In the UK, we particularly need to address the current shortage of palliative care doctors in the NHS, where training numbers are not going up to match demand, but the shortage is even greater in developing countries,” says co-author Rowan Calloway.

“In the future, community care will be increasingly reliant on non-specialists, so it will be crucial that all members of the multi-disciplinary teams needed to support very frail older people near the end of their lives have good training in palliative and supportive care skills.”

The study was supported by the Abbeyfield Society, Bupa Foundation, Medical Research Council, and the National Institute for Health Research Collaboration for Leadership in Applied Health and Care Cambridgeshire & Peterborough.

Reference
Fleming, J et al. Dying comfortably in very old age with or without dementia in different care settings – a representative "older old" population study. BMC Geriatrics; 26 Sept 2017; DOI: 10.1186/s12877-017-0605-2

Key findings and policy implications

The Cambridge City over - 75s Cohort Study

Heritage is a word that conjures up images of national treasures and the preservation of ancient traditions. All that is changing. In a world in which the forces of globalisation and fragmentation appear to be pulling communities in opposite directions heritage has found itself at the centre of many of today’s big political and philosophical questions.

“Heritage is now a word that is heard everywhere, a symptom perhaps of a crisis of identity in a globalised world,” says Dr Dacia Viejo Rose, Lecturer in Heritage and the Politics of the Past. “There is a buzz around heritage today as people start to think about it in new ways, linking it with political, economic and environmental issues.”

Some of those debates include the contentious issue of memorials and memorialisation - witness the debate around the confederate statues in the US or decolonisation in the UK and South Africa - forced migration, trafficking of artefacts and sustainable development.

A new research centre launches at the University of Cambridge this autumn which aims to bring a unique, interdisciplinary perspective to the subject. Grounded in Archaeology, the Cambridge Heritage Research Centre seeks to link disciplines as diverse as Classics, Criminology, Education, Asian and Middle Eastern Studies and Land Economy, and to bring in policymakers and practitioners to discuss and influence some of the big issues of the day and how we understand the role of heritage plays in them.

Professor Marie-Louise Stig Sørensen, co-director of the new centre, says its establishment is a response to a changing world: "Heritage refers to the use of the past and due to the globalisation and mediasation of our lives these centrally important dimensions of how societies form themselves and manage change are changing very fast - we need to understand these processes of heritage making and their effects better."

Unlike other research bodies in Europe which are looking at sustainable heritage issues or taking a critical approach to heritage, the Cambridge centre’s focus will be broader and will not follow any particular theoretical framework. “We will explore the nature of heritage and the process of meaning making which always happens in the present,” says co-director Dr Viejo Rose.
There are many researchers at the university who are already working on areas linked to what the research centre will investigate, but they may not use the word heritage to describe it or may use it in different ways. The centre will bring them together.

Subjects such as Land Economy cover sustainable development and the commercialisation of heritage through tourism. Dr Viejo Rose says: “Often heritage is brought in as if it was magic fairy dust, creating jobs and attracting tourists, but it can fuel tensions over ownership of the heritage and its commercialisation.” Criminology covers the looting and illicit trade of cultural objects, criminal networks and the trafficking both of culture, ideas and people.

The centre will also seek to look at the overlap between protection of heritage and nature conservation and at migration issues. “It is in part about roots, and but increasingly also about routes,” says Dr Viejo Rose, “about how heritage moves, what gets left behind, what is taken on journeys, what hybrid forms are created in different places.”

She has recently collaborated on a research study with Syrian tour guides in Berlin museums through the project “Multaka: Museums as Meeting Point”. The guides were asked for their views on the Arch of Palmyra. “They felt a sense of loss about the destruction, but what they grieved for most acutely was not the Arch, but rather the tradition of routine gatherings with neighbours, friends and family that was at the heart of Syrian community. Organisations like UNESCO often focus on the extraordinary aspects of heritage, whereas significant expressions of heritage are often to be found in the ordinary. Protection and reparation measures need to find a balance between the two,” she says.

The centre is holding three pre-launch events on rebuilding Syria at the Cambridge Festival of Ideas from 21st October in a bid to encourage as broad a range of people as possible to think about some of the issues around heritage.

The events, “Restoring truth to ruins?”, include a three-week exhibition at the Central Library, a workshop with art installations, virtual reality headsets with scans of heritage sites in Syria before and after the war and 3D printed artefacts and a panel discussion with artists and academics.

The theme of this year's Festival is truth and so these events will explore what truth means in terms of heritage and whose truth is being reflected in reparation projects - issues which are at the heart of discussions around reconstruction, reproduction and authenticity.

All three events look to address questions such as whether you can ever fully restore a heritage site that has been lost and what you gain and lose in the process of restoration as well as why certain artefacts acquire meaning and become important.

"The aim is to get people of all ages to think about what reconstruction might involve," says Sarah Nankivell who was a research assistant on the exhibition and is now working for the Forensic Architecture group at Goldsmith's. She adds: "We want people to ask, for example, what impact the process of reconstruction or reinterpretation might have on both the original and its replica and whether that changes the meaning or increases/decreases the value of either. Heritage has been a deliberate target of war over history, but now we have the technology to look at preservation in new ways which brings new questions. Heritage often says more about the people who are living now than those who lived in the past. It reflects the values of the present and what people want to bring from the past into the present."
 

The new Blade Runner sequel will return us to a world where sophisticated androids made with organic body parts can match the strength and emotions of their human creators. As someone who builds biologically inspired robots, I’m interested in whether our own technology will ever come close to matching the “replicants” of Blade Runner 2049.

The reality is that we’re a very long way from building robots with human-like abilities. But advances in so-called soft robotics show a promising way forward for technology that could be a new basis for the androids of the future.

From a scientific point of view, the real challenge is replicating the complexity of the human body. Each one of us is made up of millions and millions of cells, and we have no clue how we can build such a complex machine that is indistinguishable from us humans. The most complex machines today, for example the world’s largest airliner, the Airbus A380, are composed of millions of parts. But in order to match the complexity level of humans, we would need to scale this complexity up about a million times.

There are currently three different ways that engineering is making the border between humans and robots more ambiguous. Unfortunately, these approaches are only starting points, and are not yet even close to the world of Blade Runner.

There are human-like robots built from scratch by assembling artificial sensors, motors and computers to resemble the human body and motion. However, extending the current human-like robot would not bring Blade Runner-style androids closer to humans, because every artificial component, such as sensors and motors, are still hopelessly primitive compared to their biological counterparts.

There is also cyborg technology, where the human body is enhanced with machines such as robotic limbs, wearable and implantable devices. This technology is similarly very far away from matching our own body parts.

Finally, there is the technology of genetic manipulation, where an organism’s genetic code is altered to modify that organism’s body. Although we have been able to identify and manipulate individual genes, we still have a limited understanding of how an entire human emerges from genetic code. As such, we don’t know the degree to which we can actually programme code to design everything we wish.

Soft robotics: a way forward?

But we might be able to move robotics closer to the world of Blade Runner by pursuing other technologies, and in particular by turning to nature for inspiration. The field of soft robotics is a good example. In the last decade or so, robotics researchers have been making considerable efforts to make robots soft, deformable, squishable and flexible.

This technology is inspired by the fact that 90% of the human body is made from soft substances such as skin, hair and tissues. This is because most of the fundamental functions in our body rely on soft parts that can change shape, from the heart and lungs pumping fluid around our body to the eye lenses generating signals from their movement. Cells even change shape to trigger division, self-healing and, ultimately, the evolution of the body.

The softness of our bodies is the origin of all their functionality needed to stay alive. So being able to build soft machines would at least bring us a step closer to the robotic world of Blade Runner. Some of the recent technological advances include artificial hearts made out of soft functional materials that are pumping fluid through deformation. Similarly, soft, wearable gloves can help make hand grasping stronger. And “epidermal electronics” has enabled us to tattoo electronic circuits onto our biological skins.

Softness is the keyword that brings humans and technologies closer together. Sensors, motors and computers are all of a sudden integrated into human bodies once they became soft, and the border between us and external devices becomes ambiguous, just like soft contact lenses became part of our eyes.

Nevertheless, the hardest challenge is how to make individual parts of a soft robot body physically adaptable by self-healing, growing and differentiating. After all, every part of a living organism is also alive in biological systems in order to make our bodies totally adaptable and evolvable, the function of which could make machines totally indistinguishable from ourselves.

It is impossible to predict when the robotic world of Blade Runner might arrive, and if it does it will probably be very far in the future. But as long as the desire to build machines indistinguishable from humans is there, the current trends of robotic revolution could make it possible to achieve that dream.

This article was originally published on The Conversation. Read the original article.

I don’t think I will ever forget the moment I sat at the bedside of a six-year-old patient and watched the consultant hand over a 13-year-old student’s design to help with the patient’s asthma treatment. It has been the culmination of a long journey that started eight years ago with the belief that children can solve real world problems as part of the mainstream Design and Technology curriculum.

Designing Our Tomorrow (DOT) is an initiative that puts authentic challenges like this at the heart of the learning experience. Asthma treatment is the epitome of such a challenge. With 5.4 million people in the UK with the condition, the NHS spends about £1 Billion on treatment, and yet 1,468 people died from asthma in 2015. Tragically, it is believed that 90% of these deaths involve preventable factors and similarly 75% of A&E admission are thought to be avoidable.

We set the challenge in schools for students to design a packaging solution that will help co-ordinate the initial treatment for young asthma patients, to put the patient and their carers on the right path to controlling what is typically a long-term condition. A recent survey highlighted that over 80% of people, of all ages, feel that their asthma is not under control. Crucially we wanted students to address the anxiety that a child feels the first time a spacer mask is placed on their face. Students watched a video of a real instance of this, where the child recoils backwards each time the mask is placed over their mouth.

This is a complex, messy problem requiring solutions that are not only effective but cheap, simple to use and scalable. When I first saw the monkey mask design, where the child becomes a monkey and the inhaler and spacer becomes a banana to feed to it, I knew we had something special. It is so simple, so elegant as a design solution, and gets to the very heart of the child’s initial anxiety. Changing that moment from fear to fun for the patient as well as other family members makes it a better experience for all.

Alongside this we have worked with students to develop posters that remind patients to always use their spacer. In addition, we have developed a simple traffic light system explaining the narrowing of airways in the lungs and why and how it can be controlled. The credit card-sized printout can be easily clipped to a healthcare professional’s ID badge so it is always to hand.

This is a significant moment in our journey as engineers and educators, and we are so grateful for all the people that have partnered with us on this journey. The list of names would be too long, but I do want to mention the organisations that have walked the journey with us. The Healthy London Partnership, Children and Young People’s programme (a collaboration of the health and social care system across London), whose passion and skill around asthma has been an inspiration. On the packaging side the British Printing Industry Federation (BPiF) and The Institute of Materials, Minerals and Mining (IOM3) who have guided us in the realities of packaging design and production; DS Smith who turned around amazing designs in such short timescales; Peter Brett Associates who believed in the project when it was just an idea; and last, but by no means least, the teachers and students who brought it to life in the classroom.

This was perfectly timed to fit with the Healthy London Partnership #AskAbout Asthma campaign and our pledge is to run the ‘Unpacking Asthma’ challenge in schools again in this academic year. We are confident that students will come up with more ideas that can help with this vital work.

It’s hard not to sound corny, but Churchill’s words come to mind for the vision we had for DOT eight years ago, “now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning”. We hope that this work will go on to play a part in transforming asthma care and help us towards our goal of equipping future generations to be creative problem solvers. In other words, for young people to design a better tomorrow.
 

The study, reported in the journal Science, examined genetic information from the remains of anatomically modern humans who lived during the Upper Palaeolithic, a period when modern humans from Africa first colonised western Eurasia. The results suggest that people deliberately sought partners beyond their immediate family, and that they were probably connected to a wider network of groups from within which mates were chosen, in order to avoid becoming inbred.

This suggests that our distant ancestors are likely to have been aware of the dangers of inbreeding, and purposely avoided it at a surprisingly early stage in prehistory.

The symbolism, complexity and time invested in the objects and jewellery found buried with the remains also suggests that it is possible that they developed rules, ceremonies and rituals to accompany the exchange of mates between groups, which perhaps foreshadowed modern marriage ceremonies, and may have been similar to those still practised by hunter-gatherer communities in parts of the world today.

The study’s authors also hint that the early development of more complex mating systems may at least partly explain why anatomically modern humans proved successful while other species, such as Neanderthals, did not. However, more ancient genomic information from both early humans and Neanderthals is needed to test this idea.

The research was carried out by an international team of academics, led by the University of Cambridge, UK, and the University of Copenhagen, Denmark. They sequenced the genomes of four individuals from Sunghir, a famous Upper Palaeolithic site in Russia, which is believed to have been inhabited about 34,000 years ago.

The human fossils buried at Sunghir represent a rare and highly valuable source of information because, very unusually for finds from this period, the people buried there appear to have lived at the same time and were buried together. To the researchers’ surprise, however, these individuals were not closely related in genetic terms; at the very most, they were second cousins. This is true even in the case of two children who were buried head-to-head in the same grave.

Professor Eske Willerslev, a Fellow at St John’s College, Cambridge, Prince Philip Professor of Ecology and Evolution in the Department of Zoology, and a Professor at the University of Copenhagen, was the senior author on the study. “What this means is that even people in the Upper Palaeolithic, who were living in tiny groups, understood the importance of avoiding inbreeding,” he said. “The data that we have suggest that it was being purposely avoided.”

“This means that they must have developed a system for this purpose. If small hunter–gatherer bands were mixing at random, we would see much greater evidence of inbreeding than we have here.”

Early humans and other hominins such as Neanderthals appear to have lived in small family units. The small population size made inbreeding likely, but among anatomically modern humans it eventually ceased to be commonplace; when this happened, however, is unclear.

“Small family bands are likely to have interconnected with larger networks, facilitating the exchange of people between groups in order to maintain diversity,” Professor Martin Sikora, from the Centre for GeoGenetics at the University of Copenhagen, said.

Sunghir contains the burials of one adult male and two younger individuals, accompanied by the symbolically-modified incomplete remains of another adult, as well as a spectacular array of grave goods. The researchers were able to sequence the complete genomes of the four individuals, all of whom were probably living on the site at the same time. These data were compared with information from a large number of both modern and ancient human genomes.

They found that the four individuals studied were genetically no closer than second cousins, while an adult femur filled with red ochre found in the children’s’ grave would have belonged to an individual no closer than great-great grandfather of the boys. “This goes against what many would have predicted,” Willerslev said. “I think many researchers had assumed that the people of Sunghir were very closely related, especially the two youngsters from the same grave.”

The people at Sunghir may have been part of a network similar to that of modern day hunter-gatherers, such as Aboriginal Australians and some historical Native American societies. Like their Upper Palaeolithic ancestors, these people live in fairly small groups of around 25 people, but they are also less directly connected to a larger community of perhaps 200 people, within which there are rules governing with whom individuals can form partnerships.

“Most non-human primate societies are organised around single-sex kin where one of the sexes remains resident and the other migrates to another group, minimising inbreeding,” Professor Marta Mirazón Lahr, from the Leverhulme Centre for Human Evolutionary Studies at the University of Cambridge, said. “At some point, early human societies changed their mating system into one in which a large number of the individuals that form small hunter-gatherer units are non-kin. The results from Sunghir show that Upper Palaeolithic human groups could use sophisticated cultural systems to sustain very small group sizes by embedding them in a wide social network of other groups.”

By comparison, genomic sequencing of a Neanderthal individual from the Altai Mountains who lived around 50,000 years ago indicates that inbreeding was not avoided. This leads the researchers to speculate that an early, systematic approach to preventing inbreeding may have helped anatomically modern humans to thrive, compared with other hominins.

This should be treated with caution, however: “We don’t know why the Altai Neanderthal groups were inbred,” Sikora said. “Maybe they were isolated and that was the only option; or maybe they really did fail to develop an available network of connections. We will need more genomic data of diverse Neanderthal populations to be sure.”

Willerslev also highlights a possible link with the unusual sophistication of the ornaments and cultural objects found at Sunghir. Group-specific cultural expressions may have been used to establish distinctions between bands of early humans, providing a means of identifying who to mate with and who to avoid as partners.

“The ornamentation is incredible and there is no evidence of anything like that with Neanderthals and other archaic humans,” Willerslev added. “When you put the evidence together, it seems to be speaking to us about the really big questions; what made these people who they were as a species, and who we are as a result.”

The research paper, Ancient genomes show social and reproductive behaviour of early Upper Paleolithic foragers, is published in the October 5 issue of Science.